Criminal Responsibility in Asperger's Syndrome

Abstract: Background: Asperger's syndrome (AS) has been of much interest in the last two decades. Most people with AS are law abiding and are not involved in any violence. Over the years, however, there is increasing evidence of violent behavior and criminal acts committed by some people with AS. The characteristics of the link between AS and violation of the law requires identification and definition and the question regarding the criminal responsibility to be attributed to these offenders needs to be clarified. Data: We present three cases that illustrate how the special characteristics of this syndrome and particularly the inability to assess social situations and appreciate others' point of view constitute the main cause for the violent behavior and the criminal offences. For this specific behavior, the AS patients lack the criminal intent or the intent to cause harm (mens rea), which is essential for criminal responsibility. Thus it is reasonable to consider some AS sufferers not criminally responsible for their actions and unfit to stand trial. This approach has been accepted by the courts. Conclusion: It can be inferred that people with AS may not be criminally responsible despite not suffering from a psychotic illness.

Introduction

Hans Asperger, a Viennese physician, described in 1944 a group of boys who had significant social problems but whose language and cognitive skills were normal (1). These children were pedantic and preoccupied with idiosyncratic interests. They were awkward with regard to their motor skills, similar to their fathers. These disorders had some similarity to Kanner's description, one year earlier, of infantile autism (2). Asperger published in German, therefore the interest in the disorder increased only after the important review by Lorna Wing in 1981 (3). In the English literature it was established as a disorder whose symptoms are lack of empathy, social isolation, intensive preoccupation with unique and unusual subjects, coordination disturbances and clumsy movement. The disorder was included in the DSM-IV (4) and the ICD-IO (5), emphasizing the sustained impairments in social interaction and the restricted repetitive patterns of behavior.

Asperger s syndrome (AS) tends to be more apparent in late puberty and early adulthood, due to the marked importance of social communication during this period of life. Thus, despite this being a neurodevelopmental disturbance which appears in early childhood, most of its clinical expressions and the significant impairment it causes will appear at this stage, leading in many cases to relatively late diagnosis. Individuals with AS display a wide spectrum of behavioral responses to distress ranging from isolation and withdrawal to aggression and criminal behavior. In her first review, Wing (3) describes people suffering from AS who experienced bouts of violence and criminal behavior.

Over the years, following Wing's review, the descriptions of events relating AS to criminal behavior increased. This behavior may result from a change in routine or from running into a social situation which people with AS are unable to understand and, therefore, perceive as threatening. They display intense preoccupation with their special areas of interest and may react violently when disturbed or prevented from doing something related to these interests. They lack empathy and the ability to associate actions with their results (6, 7). They may be highly provoked by noise (8), and sometimes, in an attempt to be liked by others, they may be persuaded by these others to commit thefts, physical and sexual assaults, etc. (9).

The criminal behaviors described in the literature are of a large variety and are often strange, unusual and bizarre to the extreme. They include physical and sexual assaults (10), arson (11, 12), harassing phone calls and theft of personal items (13), theft of personal items for the purpose of hoarding (14), attempted murder (15), murder (16) and, possibly, even serial murders (17). …

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